Coast Plaza Doctors Hospital

Total Number of Beds: 12	Percent of Occupied Beds: 25%
Total Number of Residents: 3	Located Within a Hospital: Yes
Type of Ownership: For profit - Partnership	Multiple Nursing Homes by Same Owner: No
Councils the Nursing Home Participates in: None	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 08/31/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

Number of LPN/LVN Hours per Nursing Home Resident per Day:

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

** Details Last Reported on: 8/31/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-06-14	2001-07-30	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Environmental Deficiencies	Provide needed housekeeping and maintenance.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Quality Care Deficiencies	Give each resident care and services to get or keep the highest quality of life possible.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Minimal harm or potential for actual harm
2001-06-14	2001-07-30	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Pharmacy Service Deficiencies	At least once a month, have a licensed pharmacist check the drugs that each resident takes.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Administration Deficiencies	Get services outside the nursing home that meet professional standards.	Pattern	Potential for minimal harm
2001-06-14	2001-07-30	Administration Deficiencies	Train all employees on what to do in an emergency.	Pattern	Potential for minimal harm
2002-08-16	2002-09-26	Resident Rights Deficiencies	Tell the resident completely about his or her health status.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Resident Assessment Deficiencies	Make a complete assessment that covers all questions for areas that are listed in official regulations.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Resident Assessment Deficiencies	1) Develop a complete care plan within 7 days of each resident's admission; 2) prepare a care plan with the care team, including the primary nurse, doctor, resident or resident's family or representative; or 3) check and update the care plan.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Resident Assessment Deficiencies	Provide a final summary of the resident's health status and a summary of the resident's stay, when the resident is ready to leave the nursing home.	Pattern	Potential for minimal harm
2002-08-16	2002-09-26	Resident Assessment Deficiencies	Develop a plan with the resident and family for the resident's care after leaving the nursing home.	Pattern	Potential for minimal harm
2002-08-16	2002-09-26	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Pattern	Potential for minimal harm
2002-08-16	2002-09-26	Environmental Deficiencies	Keep all essential equipment working safely.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Environmental Deficiencies	Have enough backup water supply for important areas of the nursing home.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Administration Deficiencies	Get services outside the nursing home that meet professional standards.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Administration Deficiencies	Quickly tell the resident's doctor the results of lab tests.	Pattern	Potential for minimal harm
2002-08-16	2002-09-26	Administration Deficiencies	Keep accurate and appropriate medical records.	Isolated	Minimal harm or potential for actual harm
2002-08-16	2002-09-26	Administration Deficiencies	Have a detailed, written plan for disasters and emergencies.	Isolated	Minimal harm or potential for actual harm
2003-08-31	2003-09-19	Resident Rights Deficiencies	Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transferred or discharged.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Nutrition and Dietary Deficiencies	Store, cook, and give out food in a safe and clean way.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Environmental Deficiencies	Have a program to keep infection from spreading.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Environmental Deficiencies	Keep a resident apart from the others if the resident has an infection that can spread.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Environmental Deficiencies	Move, clean and store sheets, towels and other linens in a way that prevents the spread of infection.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable.	Pattern	Potential for minimal harm
2003-08-31	2003-09-19	Administration Deficiencies	Keep accurate and appropriate medical records.	Pattern	Potential for minimal harm

*** All violations listed are based on federal government records.